*Urban Institute Research*__

Enhanced premium tax credits (PTCs) were a key element of the American Rescue Plan Act passed by Congress in March 2021 and were extended through 2025 under the Inflation Reduction Act of 2022. The enhanced PTCs substantially increased the subsidies available for people to buy insurance in the Marketplace: they reduced net premiums to zero for some people with low incomes and made subsidies available to people with higher incomes for the first time. As a result, Marketplace enrollment steadily increased, reaching a new high of over 24 million plan selections for 2025.

In this brief, we estimate the impact on coverage of the expiration of enhanced PTCs that would occur in 2026 without action by Congress. Our estimates include the major Marketplace provisions of the One Big Beautiful Bill Act (OBBBA) that will be in effect for 2026 (most will be implemented later) and the provisions of the Marketplace Integrity and Affordability rule released by the Center for Medicare and Medicaid Services (CMS) that will be in effect for 2026, excluding those provisions stayed because of an August 22 decision by a Maryland District Court.

Link to full brief, fact sheet on veterans' coverage and congressional district data